Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
Division of Orthopaedic Surgery, University of Toronto, 149 College Street Room 508-A, Toronto, ON, M5T 1P5, Canada.
Eur Spine J. 2022 Oct;31(10):2461-2472. doi: 10.1007/s00586-022-07291-y. Epub 2022 Jun 29.
Conduct a systematic review to quantify the effect of primary sacroiliac joint fusion (SIJF) for the treatment of sacroiliac (SI) joint pathology on patient reported outcomes.
Medline, Embase, Cochrane, PubMed, and Scopus databases were searched prior to August 18th, 2020 for all English-Language studies involving the treatment of SIJ pathology through SIJF and/or conservative management (CM). The quality of included studies was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Primary outcome measure was the Visual Analogue Scale (VAS) for low back pain. Secondary outcome measure was the Oswestry Disability Index (ODI) and the incidence of adverse reactions.
A total of 564 patients and six studies were included. The overall quality of evidence analyzed by this review was low (GRADE = 0). Five out of the six studies were industry funded. The VAS standardized mean difference (SMD) between SIJF and CM at three months and six months follow-up was - 1.4 [95% confidence interval - 2.3, - 0.6] and - 1.5 [95% CI - 1.8, - 1.1]. The ODI SMD between SIJF and CM scores at three months and 6 months follow-up was - 0.9 [95% CI - 1.1, - 0.7] and - 1.1 [95% CI - 1.6, - 0.5]. The odds ratio of adverse reactions due to SIJF compared to CM was 1.9 [95% CI 0.1, 42.8].
Based on the limited number of independent trials with long-term follow-up, SIJF shows potential as a surgical treatment option for SIJ pathology.
CRD42020206149 (25th September 2020).
进行系统评价，量化原发性骶髂关节融合（SIJF）治疗骶髂（SI）关节病变对患者报告结局的影响。
在 2020 年 8 月 18 日之前，检索了 Medline、Embase、Cochrane、PubMed 和 Scopus 数据库，以获取所有涉及通过 SIJF 和/或保守治疗（CM）治疗 SIJ 病变的英文研究。使用推荐评估、制定和评估（GRADE）对纳入研究的质量进行评估。主要结局测量指标是下腰痛视觉模拟量表（VAS）。次要结局测量指标是 Oswestry 残疾指数（ODI）和不良反应发生率。
共纳入 564 名患者和 6 项研究。本综述分析的证据总体质量较低（GRADE=0）。6 项研究中有 5 项为行业资助。SIJF 与 CM 在 3 个月和 6 个月随访时 VAS 标准化均数差值（SMD）分别为-1.4[95%置信区间-2.3，-0.6]和-1.5[95%置信区间-1.8，-1.1]。SIJF 与 CM 在 3 个月和 6 个月随访时 ODI SMD 分别为-0.9[95%置信区间-1.1，-0.7]和-1.1[95%置信区间-1.6，-0.5]。与 CM 相比，由于 SIJF 引起的不良反应的优势比为 1.9[95%置信区间 0.1，42.8]。
基于具有长期随访的独立试验数量有限，SIJF 作为治疗 SIJ 病变的一种手术治疗选择具有潜力。
PROSPERO 注册号：CRD42020206149（2020 年 9 月 25 日）。
